| FORM 990, BOX C, DOING BUSINESS AS NAMES: |
MERCY ONCOLOGY SERVICES MERCY ONCOLOGY SERVICES, INC MERCY MEDICAL GROUP, INC. DBA MERCY ONCOLOGY SERVICES MERCY MEDICAL GROUP, INC. DBA PIONEER CONTINUING CARE PHYSICIANS |
| FORM 990, PART VI, SECTION A, LINE 6 |
ON DECEMBER 30,2016, SISTERS OF PROVIDENCE HEALTH SYSTEM, THE SOLE MEMBER OF MERCY MEDICAL GROUP, WAS MERGED INTO THE MERCY HOSPITAL, A RELATED ORGANIZATION. THEREFORE, ON DECEMBER 30, 2016, THE SOLE MEMBER OF MERCY MEDICAL GROUP IS THE MERCY HOSPITAL. SEE LINE 7 FOR ADDITIONAL INFORMATION. |
| FORM 990, PART VI, SECTION A, LINE 7A |
THE MERCY HOSPITAL IS THE SOLE MEMBER OF MERCY MEDICAL GROUP. THE MERCY HOSPITAL HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MERCY MEDICAL GROUP. |
| FORM 990, PART VI, SECTION A, LINE 7B |
AS SOLE MEMBER, THE MERCY HOSPITAL MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. THE MERCY HOSPITAL MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. |
| FORM 990, PART VI, SECTION B, LINE 11B |
PRIOR TO FILING, THE FORM 990 FOR MERCY MEDICAL GROUP IS REVIEWED BY MANAGEMENT. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C |
MERCY MEDICAL GROUP HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MERCY MEDICAL GROUP, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCY MEDICAL GROUP AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MERCY MEDICAL GROUP (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCY MEDICAL GROUP OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCY MEDICAL GROUP (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MERCY MEDICAL GROUP. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 15 |
QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MERCY MEDICAL GROUP WAS ESTABLISHED BY SISTERS OF PROVIDENCE HEALTH SYSTEM, A RELATED ORGANIZATION THAT WAS MERGED INTO THE MERCY HOSPITAL EFFECTIVE DECEMBER 30, 2016. THE PROCESS FOR ESTABLISHING THE COMPENSATION FOR THE CEO AND OTHER MANAGEMENT OFFICIALS INCLUDES THE FOLLOWING: THE BOARD HAS AN INDEPENDENT COMMITTEE REVIEW AND APPROVE ALL ELEMENTS OF REMUNERATION FOR THESE EXECUTIVES. THE BOARD/COMMITTEE HAS AN ESTABLISHED COMPENSATION PHILOSOPHY WHICH DETAILS THE OBJECTIVES OF MARKET POSITIONING AND PAY ELEMENTS. THE COMMITTEE ENGAGES WITH EXTERNAL CONSULTANTS TO PROVIDE MARKET DATA COMPARING THE ORGANIZATION'S ROLES TO SIMILARLY-SIZED HEALTH SYSTEMS UTILIZING BOTH TITLE AND JOB CONTENT COMPARISONS. ON AN ANNUAL BASIS, THE COMMITTEE REVIEWS THE MARKET ANALYSIS, APPROVES ANY SALARY ADJUSTMENTS FOR THE EXECUTIVE POPULATION, CONSIDERS BOTH REASONABLENESS AND EFFECTIVENESS OF ALL REMUNERATIVE PROGRAMS, AND ESTABLISHES THE DETAILED PERFORMANCE EXPECTATIONS WHICH ARE INCORPORATED INTO THE INCENTIVE PLAN. ALL OF THESE DISCUSSIONS AND DECISIONS ARE DOCUMENTED THROUGH THE PROVISION OF MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 |
MERCY MEDICAL GROUP IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. MERCY MEDICAL GROUP'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G |
MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 2,988,847. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,988,847. CONSULTING FEES: PROGRAM SERVICE EXPENSES 6,509. MANAGEMENT AND GENERAL EXPENSES 541. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,050. MISC. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,730,243. MANAGEMENT AND GENERAL EXPENSES 143,903. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,874,146. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 3,910. MANAGEMENT AND GENERAL EXPENSES 325. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,235. BILLING SERVICES: PROGRAM SERVICE EXPENSES 847,364. MANAGEMENT AND GENERAL EXPENSES 70,475. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 917,839. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 47,495. MANAGEMENT AND GENERAL EXPENSES 3,950. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,445. |
| FORM 990, PART XII, LINE 2: |
MERCY MEDICAL GROUP'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY17 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. |
Attach to Form 990 or 990-EZ.